• Alison Lee, Leon Hsu Hsiao-Hsien HH Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Pediatrics, Kravis Ch, Mathilda Chiu Yueh-Hsiu YH Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Pediatrics, Kravis, Sonali Bose, Maria José Rosa, Itai Kloog, Ander Wilson, Joel Schwartz, Sheldon Cohen, Brent A Coull, Robert O Wright, and Rosalind J Wright.
• Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
• J. Allergy Clin. Immunol. 2018 May 1; 141 (5): 1880-1886.

BackgroundThe impact of prenatal ambient air pollution on child asthma may be modified by maternal stress, child sex, and exposure dose and timing.ObjectiveWe prospectively examined associations between coexposure to prenatal particulate matter with an aerodynamic diameter of less than 2.5 microns (PM2.5) and maternal stress and childhood asthma (n = 736).MethodsDaily PM2.5 exposure during pregnancy was estimated using a validated satellite-based spatiotemporally resolved prediction model. Prenatal maternal negative life events (NLEs) were dichotomized around the median (high: NLE ≥ 3; low: NLE < 3). We used Bayesian distributed lag interaction models to identify sensitive windows for prenatal PM2.5 exposure on children's asthma by age 6 years, and determine effect modification by maternal stress and child sex.ResultsBayesian distributed lag interaction models identified a critical window of exposure (19-23 weeks' gestation, cumulative odds ratio, 1.15; 95% CI, 1.03-1.26; per interquartile range [1.7 μg/m3] increase in prenatal PM2.5 level) during which children concomitantly exposed to prenatal PM2.5 and maternal stress had increased risk of asthma. No significant association was seen in children born to women reporting low prenatal stress. When examining modifying effects of prenatal stress and fetal sex, we found that boys born to mothers with higher prenatal stress were most vulnerable (19-21 weeks' gestation; cumulative odds ratio, 1.28; 95% CI, 1.15-1.41; per interquartile range increase in PM2.5).ConclusionsPrenatal PM2.5 exposure during sensitive windows is associated with increased risk of child asthma, especially in boys concurrently exposed to elevated maternal stress.Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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